Niacin scams 12. January 2009 William Davis (0) In the Track Your Plaque program, we often resort to niacin (vitamin B3 or nicotinic acid) to: --Raise HDL cholesterol--Reduce the proportion of small LDL particles--Shift HDL towards the healthy larger fraction (HDL2b or "large")--Reduce lipoprotein(a), the most aggressive risk factor known But niacin comes with a crazy "hot flush," a warm, prickly feeling that usually envelops the upper chest, neck and face that is, without a doubt, annoying. Around 1 in 20 people simply cannot tolerate any amount of niacin >100 mg, while others have no problem even into the 3000 mg per day or more range. (Tolerance to niacin is genetically determined, governed by the rapidity of metabolism to the niacin metabolite, nicotinuric acid.)The niacin flush has spawned an entire panel of niacin-like scams, agents that sound like niacin or may even contain niacin, but exert no beneficial effect whatsoever:Flush-free niacin--I have previously posted on this useless but ubiquitous preparation that often costs several times more than conventional niacin. Flush-free niacin, or inositol hexaniacinate, does indeed contain niacin, but it is not released in the human body. You simply pass it out down the toilet, where this preparation belongs in the first place. Nicotinamide--Also called niacinamide. While the nicotinamide/niacinamide forms of vitamin B3 can be used to treat B3 deficiency ("pellagra"), they do not reproduce the lipid and lipoprotein effects of niacin. For our purposes, they are useless. Niacin-containing heart-healthy supplements--These are the multi-supplements that contain a little of everything that might be beneficial for the heart, but none at a dose that provides genuine benefit. Don't throw your money away. There's also a prescription niacin, Niaspan, that costs 20-fold more than the best over-the-counter preparation, Sloniacin. Niaspan has yielded hundreds of millions of dollars for the pharmaceutical industry. Your money, in my view, is far better spent on Sloniacin (around $12-14 per bottle of 100 tablets of 500 mg). For more on niacin, here's an article I wrote for the Life Extension Magazine people a while back: Using Niacin to Improve Cardiovascular Health.
Deja vu all over again? 10. January 2009 William Davis (8) HeartHawk brought a report and debate on The Heart.Org website to my attention: Screening for risk factors or detecting disease? Debate divides the CV community. After landing on theheart.org, paste this onto your URL address:article/883239.do. (Full address: http://www.theheart.org/article/883239.do. I don't know why, but I couldn't go there directly.)Some interesting comments: Dr. Jay Cohn (University of Minnesota):"They're saying that we can't identify disease very effectively so let's just stick with risk factors, which we know are very poorly predictive and nonspecific. It boggles my mind as to why they won't open up their minds to the importance of moving forward in finding better strategies to identify the disease that we are treating. It's very strange. They criticize these disease markers because they are not predictive of events, but they are looking at very short-term outcomes. We're interested in lifetime risk. We're screening people in their 40s who are concerned about morbid events in their 60s and 70s, and no trials are going to track them that long.""You have to accept the pathophysiologic reality that heart attacks don't occur in the absence of coronary disease, and coronary disease doesn't occur in the absence of endothelial dysfunction and vascular disease, all of which now can be identified."". . . Can we as a society and as a profession accept the idea that there is a link between the vascular abnormalities and the events? "And that that linkage is tight enough that it should allow us to accept slowing of progression of the vascular abnormalities as an adequate marker for slowing disease progression, without waiting for events to occur? As soon as you use the word surrogate, people jump up and say we have all these markers that we know don't work well—things like premature ventricular contractions [PVCs] on the electrocardiogram, LDL, HDL—but those are not the markers we're talking about. We're talking about structural and functional changes in the blood vessel and in the heart."Wow. The idea may be starting to catch on. As an interesting aside, Cohn et al use a 10-test panel to screen for vascular disease: "Named for the center's benefactor, the Rasmussen score includes tests for large and small artery elasticity (compliance), resting blood pressure, blood-pressure response to moderate treadmill exercise, optic fundus photography, carotid intimal-media thickness (IMT), microalbuminuria, electrocardiography, left ventricular (LV) ultrasonography for LV volume and mass, and brain natriuretic peptide (BNP). Each test result is scored out of 10 for low, intermediate, or high risk, and the combined results yields a score that Cohn et al believe is more predictive than any of the existing standalone tests."The counterarguments in this debate were provided by Dr. Philip Greenland (Northwestern University), who repeated his oft-used argument that, while he accepts that vascular disease can be identified, no one has proven that measuring it improves outcomes: "We do have that evidence for risk-factor screening. Even though people criticize risk-factor assessment because it is not sensitive enough or not accurate enough, the interesting and curious thing is that we actually have evidence that if you go to the trouble of screening for risk factors and treating them, patients have better outcomes. We do not have that evidence for any of these other tests."An interesting debate ensues that includes Track Your Plaque friend, Dr. William Blanchet, who characteristically argues persuasively in favor of broad screening for coronary disease with coronary calcium scoring:"If we were doing our jobs in primary prevention, we would not need to look at improved intervention and secondary prevention to reduce coronary death."Here's a shock: Dr. Melissa Shirley-Walton, the cardiologist who previously preached the "cath lab on every corner" argument seems to have undergone a change of heart:"What if I walked up to a gentleman and said, "you are at risk for CAD, take a statin", to which he replies, "I'm afraid of those meds". BUT if he sees his calcium score........he is then convinced to be pro-active. What is so wrong with that? What is so wrong with allowing him to spend 250.00 US out of pocket in order to save the US 150,000.00 US later on? No hard endpoints you say with intensive therapy for primary prevention? What about extrapolating from trials for secondary prevention like HATS? ARBITER2? And what exactly is the true definition of secondary prevention? Is it truly primary prevention if we already have intima thickness abnormalities, or fatty streaks? That would more likely fall under secondary prevention by today's new standards. So, I'm all for any visual aid that will encourage compliance with life style change, necessary medical therapy and followup. If the patient is willing to spend 250.00$ to get a calcium score, so be it. Better yet, why not lower the price so everyone can have the option if they are motivated enough to seize an opportunity?"I have to admit that I thought that Dr. Blanchet was wasting his time trying to persuade Shirley-Walton et al, but perhaps he is having an impact, though having hammered away at them for the last year or so. These arguments, for me, eerily echo many previous debates I've heard. But I am encouraged by the more favorable treatment the notion of atherosclerosis screening is receiving. Just 5 years ago, all coronary calcium scoring would have received from the conventionalists is "more clinical studies are needed." So perhaps the cardiology and medical worlds are inching slowly towards broad acceptance of screening for coronary and vascular disease. BUT, screening is not sufficient. What do you do with the information? Here is where the conventional-thinkers stop. The question that seems to occupy them: Perhaps we should screen people for hidden coronary and vascular atherosclerosis so we can better decide who needs a statin drug or a procedure. I would pose a different challenge: We should screen people for hidden coronary and vascular atherosclerosis so we can better decide who needs to engage in an intensive program of disease reversal using natural means and as little medication and procedures as possible. Well, perhaps in time.
Lead to Gold: The alchemy of transforming nutritional-supplement-to-medication 9. January 2009 William Davis (25) Here's a recipe to make hundreds of millions of dollars. Others have done it and you can do it, too!1) Identify a nutritional supplement that works. Find some agent deemed to fall within the broad allowances of the 1994 Dietary Supplement Health and Education Act . However, because this agent is already in the public domain and is essential non-patent-protectable, you may need to develop some patent protectable aspect of its production, application, or encapsulation. This patent-protected aspect may or may not provide genuine advantage, but that's not your concern. Your concern is protecting your investment and providing the appearance of exclusivity. 2) Identify a medical indication for your product. Choose a disease or condition that is likely to yield unquestioned efficacy, e.g., omega-3 fatty acids to reduce high triglycerides in people with familial hypertriglyceridemia (triglycerides >500 mg/dl). While this will restrict your ability to make market claims, it will not restrain your ability to sell or allow use of your agent for "off-label" applications. In fact, there are methods to surreptitiously promote the use of your product for off-label use, such as hiring experts to discuss the science behind your product with doctors who can prescribe your product. Ideally, your product's primary indication will provide a substantial market on its own to justify your investment. However, the eventual off-label sales can be substantial, even outstripping the sales generated through your primary indication. 3) Obtain at least $230 million to pay for the clinical trials required to obtain FDA approval. You will also have to raise the capital to build the business to manufacture, distribute, and sell your product. 4) After FDA approval is obtained, your business is up and running, and distribution begins, start bashing the non-FDA-approved nutritional products that stand to compete in your market. You could point out that only your product has actually passed through the rigorous FDA process. You could make claims regarding purity, potency, "approved by your doctor," etc., whether or not there is any truth behind the claim. 5) Buy that second vacation home in Aspen and the corporate jet you've been dreaming about! After all the risks you've taken, you deserve it!That's it, plain and simple. It is a tried-and-true formula that has been applied many times. It is a formula like this that brought Lovaza-brand omega-3 fatty acids to market, Niaspan brand of niacin, ergocalciferol form of vitamin D, Folbee (prescription combination B vitamins), with a slightly different spin for Synthroid (since the Armour Thyroid it is meant to replace is not a nutritional supplement, but a low-cost, generic thyroid replacement). Whatever you do, don't EVER run a head-to-head comparative trial of your agent versus the nutritional supplement competition. For instance, NEVER compare Lovaza to supplemental fish oil capsules, matched milligram-for-milligram for EPA and DHA content. NEVER compare Niaspan to over-the-counter Sloniacin. NEVER compare Armour Thyroid to Synthroid. You never know what you might find. (Psssssttt! They might be equivalent!) The formula is not a foolproof road paved with riches, however. There have been market failures, as well. Folbee, for instance, is hardly a household name. So there's risk involved, no question about it. But, should it all work out, the payoff can be big, VERY big, as it has been for Niaspan and Lovaza. So, start thinking about how you might follow this formula for:1) Cholecalciferol (vitamin D3)--e.g., for osteopenia, low HDL, or high c-reactive protein2) Vitamin K2--also for osteopenia3) Magnesium--for suppression of ventricular arrhythmias (especially Torsade de Pointes)4) Iodine--for goiter and iodine deficiency5) Vitamin C--for uric acid reductionWho said you can't turn lead into gold?
Another interview with Livin' La Vida Low Carb's Jimmy Moore 7. January 2009 William Davis (4) I recently provided another interview for Livin' La Vida Low Carb's Jimmy Moore. You may remember Jimmy as the irrepressible host of the Livin' La Vida Low Carb Show who lost around 200 lbs, dropping from 410 to 230 lbs on a low-carbohydrate diet. In this hour-long interview, we discussed some of the dietary strategies that we use in the Track Your Plaque program. Jimmy's website is definitely worth exploring. It's loaded with great interviews, including with Good Calories, Bad Calories author, Gary Taubes.
"Millions of needless deaths" 6. January 2009 William Davis (4) "Millions of needless deaths" is the title of an editorial by Life Extension Magazine's Bill Faloon.". . . If vitamin D’s only benefit was to reduce coronary heart attack rates by 142%, the net savings (after deducting the cost of the vitamin D) if every American supplemented properly would be around $84 billion each year. That’s enough to put a major dent in the health care cost crisis that is forecast to bankrupt Medicare and many private insurance plans."Although I don't agree with all the over-the-top commentary that issues from Mr. Faloon or Life Extension (although I sit on their Medical Advisory Board), I agree with virtually all of the issues he raises with vitamin D.Despite the enormously compelling observations of vitamin D potential effects in populations, the medical community's reluctance comes from the lack of treatment data. In other words, what we lack are long-term data on vitamin D supplementation vs. placebo on rate of heart attack, vitamin D vs. placebo on risk of colon cancer, etc.The data that exists connecting vitamin D levels with cardiovascular risk originate from three population observations:1) The NHANES data in 16,000 participants showed 20% increased risk of cardiovascular events in those with vitamin D levels <20>20 ng/ml after factoring in all standard risk factors.Another NHANES analysis showed the high prevalence of vitamin D deficiency in those with cardiovascular disease.2) A German study of 2500 participants that showed showed the lowest quartile of vitamin D levels (<13.3>28.4 ng/ml.3) The Health Professionals' Follow-Up Study of 18,000 males showed a 2.4-fold increase in cardiovascular events in those with vitamin D levels <15>30 ng/ml.While we lack treatment data (vitamin D vs. placebo) in a large population, we do have data that Suzie Rockway, Mary Kwasny (both from Rush University, Chicago) and I generated on the effect of vitamin D as a part of a broader treatment program on coronary calcium scores:Effect of a Combined Therapeutic Approach of Intensive Lipid Management, Omega-3 Fatty Acid Supplementation, and Increased Serum 25 (OH) Vitamin D on Coronary Calcium Scores in Asymptomatic Adults.Davis W, Rockway S, Kwasny M. Amer J Ther 2008 (Dec 15). The impact of intensive lipid management, omega-3 fatty acid, and vitamin D3 supplementation on atherosclerotic plaque was assessed through serial computed tomography coronary calcium scoring (CCS). Low-density lipoprotein cholesterol reduction with statin therapy has not been shown to reduce or slow progression of serial CCS in several recent studies, casting doubt on the usefulness of this approach for tracking atherosclerotic progression. In an open-label study, 45 male and female subjects with CCS of >/= 50 without symptoms of heart disease were treated with statin therapy, niacin, and omega-3 fatty acid supplementation to achieve low-density lipoprotein cholesterol and triglycerides /=60 mg/dL; and vitamin D3 supplementation to achieve serum levels of >/=50 ng/mL 25(OH) vitamin D, in addition to diet advice. Lipid profiles of subjects were significantly changed as follows: total cholesterol -24%, low-density lipoprotein -41%; triglycerides -42%, high-density lipoprotein +19%, and mean serum 25(OH) vitamin D levels +83%. After a mean of 18 months, 20 subjects experienced decrease in CCS with mean change of -14.5% (range 0% to -64%); 22 subjects experienced no change or slow annual rate of CCS increase of +12% (range 1%-29%). Only 3 subjects experienced annual CCS progression exceeding 29% (44%-71%). Despite wide variation in response, substantial reduction of CCS was achieved in 44% of subjects and slowed plaque growth in 49% of the subjects applying a broad treatment program.I also summed up the data as of early 2008 in a Life Extension article:Vitamin D's Crucial Role in Cardiovascular ProtectionI do agree with Mr. Faloon: It's time to take the vitamin D issue very seriously. Personally, I think it is foolhardy to not correct vitamin D deficiency, even in the absence of long-term treatment data.Should we subject people living in tropical climates with vitamin D blood levels of 90 ng/ml to long-term observation? Though that has not yet been done, it has been done--in effect--through observations on the prevalence of diabetes, heart disease, and various cancers by latitude: the farther away from the equator, the greater the prevalence of these diseases.That's more than good enough for me.
Thiazide diuretics: Treatment of choice for high blood pressure? 5. January 2009 William Davis (14) Thiazide diuretics are a popular first-line treatment for hypertension among the primary care set.This practice became especially well-established with the 2002 publication of the ALLHAT Study (Major Outcomes in High-Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic:The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)). ALLHAT showed that an inexpensive diuretic like chlorthalidone (a weak diuretic in the thiazide class, similar to hydrochlorothiazide) as first-line treatment for hypertension achieved equivalent reductions in cardiovascular events (cardiovasular death and heart attack) as non-thiazide antihypertensives, lisinopril (an ACE inhibitor) and amlodipine (a calcium channel blocker, better known as Norvasc). After 7 years of treatment, there was 14% death or heart attack among all three groups--no difference. This was interpreted to mean that inexpensive thiazide diuretics like chlorthalidone offer as much benefit as other blood pressure medications at reduced cost. On the surface, that's great. Anything that detracts from the ubiquitous pharmaceutical industry propaganda of bigger, better, more expensive drugs to replace old, inexpensive, generic drugs is fine by me. But you knew there'd be more to this issue! If we accept that thiazides are equivalent to other single-drug treatments for high blood pressure, what do we do with the following issues:--Thiazides deplete body potassium-This effect can be profound. In fact, built into the ALLHAT mortality rate is an expected death rate from potassium depletion. When potassium in the body and blood go low, the heart becomes electrically unstable and dangerous rhythms develop. --Thiazides deplete magnesium--Similar in implication to the potassium loss, magnesium loss also creates electrical instability in the heart, not to mention exaggeration of insulin resistance, rise in triglycerides, reduction in HDL.--Thiazides reduce HDL cholesterol--Thiazides increase triglycerides--Thiazides increase small LDL particles--You know, the number one cause for heart disease in the U.S. --Thiazides increase uric acid--Uric acid is increasingly looking like a coronary risk factor: The higher the uric acid blood level, the greater the risk for heart attack. Thiazides have long been known to increase uric acid, occasionally sufficient to trigger attacks of gout (uric acid crystals that precipitate in joints, like rock candy). (Fully detailed Special Report on uric acid coming this week on the Track Your Plaque website.)What about the advice we commonly give people to hydrate themselves generously? Yet we give them diuretics? Which is it: More hydration or less hydration? You can't have both. Do thiazides exert an apparent cardiovascular risk reduction in a society due to its flagrant sodium obsession? Thus, there are a number of inconsistencies in the thinking surrounding thiazides. In my experience, I have seen more harm done than good using these agents. While I cannot fully reconcile the reported benefit seen in ALLHAT with what I see in real life, all too often I see people having to take another drug to make up for a side-effect of a thiazide diuretic (e.g., high-dose prescription potassium to replace lost potassium, allopurinol to reduce uric acid, etc.). I have seen many people get hospitalized, even suffer near-fatal or fatal events from extremely low potassium or magnesium levels. My personal view: ALLHAT or no, avoid thiazide diuretics like the plague. Sure, it might save money on a population basis, but I suspect that the ALLHAT data are deeply misleading. What's better than a thiazide, calcium blocker, or ACE inhibitor? How about vitamin D restoration, thyroid normalization, wheat elimination?
"High-dose" Vitamin D 30. December 2008 William Davis (43) I stumbled on one of the growing number of local media stories on the power of vitamin D. In one story, a purported "expert" was talking about the benefits of "high-dose" vitamin D, meaning up to 1000, even 2000 units per day. I regard this as high-dose---for an infant. Judging by my experiences, now numbering well over 1000 patients over three years time, I'd regard this dose range not as "high dose," nor moderate dose, perhaps not even low dose. I'd regard it as barely adequate. Though needs vary widely, the majority of men require 6000 units per day, women 5000 units per day. Only then do most men and women achieve what I'd define as desirable: 60-70 ng/ml 25-hydroxy vitamin D blood level. I base this target level by extrapolating from several simple observations: --In epidemiologic studies, a blood level of 52 ng/ml seems to be an eerily consistent value: >52 ng/ml and cancer of the colon, breast, and prostate become far less common; <52 ng/ml and cancers are far more likely. I don't know about you, but I'd like to have a little larger margin of safety than just achieving 52.1 ng/ml. --Young people (not older people >40 years old, who have lost most of the capacity to activate vitamin D in the skin) who obtain several days to weeks of tropical sun typically have 25-hydroxy vitamin D blood levels of 80-100 ng/ml without adverse effect. More recently, having achieved this target blood level in many people, I can tell you confidently that achieving this blood level of vitamin D achieves:--Virtual elimination of "winter blues" and seasonal affective disorder in the great majority--Dramatic increases in HDL cholesterol (though full effect can require a year to develop)--Reduction in triglycerides--Modest reduction in blood pressure--Dramatic reduction in c-reactive protein (far greater than achieved with Crestor, JUPITER trial or no)--Increased bone density (improved osteoporosis/osteopenia)--Halting or reversal of aortic valve disease(I don't see enough cancer in my cardiology practice to gauge whether or not there has been an impact on cancer incidence.)My colleagues who have bothered to participate in the vitamin D conversation have issued warnings about not going "overboard" with vitamin D, generally meaning a level of >30 ng/ml. I know of no rational basis for these cautions. If hypercalcemia (increased blood calcium) is the concern, then calcium levels can be monitored. I can reass Toggle navigation Home Blog Home Archive Join Now Log in Almonds are the new wheat 29. September 2011 William Davis (31) Once you eliminate this genetically-altered Frankengrain called modern wheat, the diet should center around vegetables, nuts, healthy oils like olive and coconut, fish, meats, cheese, olives, avocados and other real whole foods. This is, in fact, the diet that I have advocated in my heart disease prevention practice, as well as my online program for prevention and reversal of heart disease. But what if you'd like a piece of cheesecake or a nice slice of dessert bread---but you don't want to gain two pounds, spend 48 hours in the bathroom suffering with diarrhea and cramps, 3 weeks of joint pains and leg swelling, wade through mental "fog," anxiety, and rage just because you had that momentary indulgence---as you would with wheat? That's why I've been focusing on recipes that allow you to have something familiar, e.g., chocolate coconut bread or biscotti, but using ingredients that will not generate the metabolic contortions triggered by wheat. On perusing these recipes, you will notice that there are recurring ingredient themes. Many of the same ingredients pop up time and again. Among the most frequent, versatile, user-friendly, and tasty: Almonds. You can use almonds as ground whole almonds, ground blanched almonds for a finer texture, ground roasted almonds, almond butter (though, for maximum health benefits, I prefer the ground whole almonds). Ground almonds allow you to recreate muffins, breads, scones, pizza crust, pie crust, biscotti, and cookies with health benefits that exceed that of whole wheat---but with none of the downside: no weight gain, no high blood sugar, no triggering of small LDL particles (#1 cause of heart disease in the U.S.), no accumulation of visceral fat, no appetite stimulation. In short, you just have your chocolate almond biscotti or mocha cupcake and enjoy it, no health price to pay. So I call almonds the new wheat, except better. Being regular is dangerous to your health 25. September 2011 William Davis (21) No, I'm not referring to your daily morning ritual in the bathroom. I'm talking about heart rate.Counterintuitively, a perfectly regular heart rate is a marker of poor health. People with perfect regularity of heart rate have more heart attacks, for instance.Regularity of heart rate occurs more commonly in people with hypertension and other metabolic derangements, and it signals increased risk for both heart attack and death. A perfectly regular heart rate, i.e., no variation in the time interval from beat to beat, suggests that the parasympathetic nervous system, the component of automatic ("autonomic") nervous system control that is associated with the relaxation response, feelings of well-being, quiet, and relaxation, is weak. It also means that the opposing sympathetic nervous sytem that regulates the "fight or flight," adrenaline-like response is allowed to be dominant. Dominance of the sympathetic over the parasympathetic system generates regularity of heart rate. Heart rate also tends to be faster, e.g., 85 beats per minutes rather than 55 or 60 beats per minute. So perfect regularity, as well as increased rate, is undesirable.What we want is irregularity of heart rate. But not irregularity that occurs chaotically with no rhyme or reason. More precisely, we want variability in heart rate. And we want variability to occur in synchrony with breathing, i.e., the respiratory cycle.The ideal response is:1) increase in heart rate with inspiration2) decrease in heart rate with expiration.Heart rate in healthy people typically varies 15-20 beats per minute within the respiratory cycle, e.g., 60 bpm at end-exhalation, 80 bpm at end-inspiration. Restoration of increased heart rate variability is associated with reduced blood pressure, reduced blood sugars (HbA1c), reduced inflammatory markers and cortisol (associated with stress), even an increase in DHEA levels. Feelings of well-being and calm also develop. Among the strategies to consider to restore heightened heart rate variability and slowed heart rate include:--Omega-3 fatty acid supplementation--Exercise--Weight loss--Deep breathing exercises--Meditation, prayer, and biofeedbackFor our Track Your Plaque purposes, we are folding in the HeartMath strategies, i.e., use of a heart rate monitor that calculates heart rate variability in the context of respiratory cycle. If you've not already done so, take a look at the two Special Reports devoted to this topic on the Track Your Plaque website. You mean weight loss is hazardous to your health? 23. September 2011 William Davis (11) In my last Heart Scan Blog post, What is this wacky thing called weight loss?, I discussed how weight loss is associated with distortions in cholesterol and blood sugar values that can be very confusing, often leading your doctor to wrongly and unnecessarily prescribe drugs--since he/she likely rarely sees weight loss.Blog reader, Donald K., posted his enlightening story: I experienced this very thing. After losing serious weight from the eliminating wheat, processed, and sugary foods (1 year in total) I lost 130 pounds. When I was nearly finished I went to see my doctor. He wanted to put me on statins. I explained to him how the data does not support application to me (no evidence of heart disease) and I got the mantra about standards of practice, etc, etc. I held my ground and decided I am much happier eating dairy, eggs, grass fed beef, wild caught fish, and as much raw foods (nuts, veggies, fruits) as my body desires to treat my health parameters. Maintaining weight, it is easy. My BMI (23 down from 40) has remained constant for a few months now. You are right: metabolic processes definitely change. I no longer have sensations of glucose fluctuations or an uncontrolled appetite. I can only imagine the improved hormone regulation and metabolic communication going on inside my body. The symptoms from obesity, all gone. Goodbye sleep apnea, hypertension, hemorrhoids, arrhythmias, gastroinestinal disruptions, smelly body, chaffing thighs, and others not mentioned. The positive effects are just as dramatic, but I don’t want to ramble on. Weight loss? What is it? Getting your life back!Brace yourself: If you are following the nutrition advice posted here and in the Track Your Plaque program, or the discussion I've initiated in Wheat Belly, then you may find yourself in the very same health predicament as Donald. Arm yourself to protect yourself against the drug-wielding ways of doctors. No, weight loss to achieve ideal weight is definitely not bad for health. But your doctor's misinterpretation of its effects can be! What is this wacky thing called "weight loss"? 20. September 2011 William Davis (41) I've discussed this before, but it has proven such an (encouragingly!) frequent issue that I thought it was worth discussing once again.What happens when you lose weight?The process of weight loss is characterized by multiple shifts in metabolic patterns that can be confusing. To the uninitiated eye, weight loss can look like a disastrous distortion in metabolism. The naive doctor on seeing your lab values, for instance, might insist you take a statin drug, a fibrate like Tricor (to reduce triglycerides or increase HDL), or simply berate you for your bad health habits--when it's actually a good thing you've accomplished.So when you lose weight, say, 30 pounds in 3 months, what have you accomplished?Energy stored as fat, especially from visceral fat stores, is mobilized into the bloodstream. It floods the bloodstream as fatty acids and triglycerides. These fatty acids and triglycerides don't occur in isolation, but interact with other particles and metabolic patterns. The resulting blood patterns include:--Increased triglycerides--An increase in triglycerides, for instance, from 90 mg/dl to 200 mg/dl in the midst of weight loss is common.--Reduced HDL--The flood of triglycerides leads to increased degradation of HDL, thus a drop. A drop in HDL from, say, 40 mg/dl to 27 mg/dl--very frightening to people--is exceptionally common.--Increased blood sugar--The flood of fatty acids and triglycerides results in insulin resistance, leading to higher blood sugars. It is not uncommon for someone with pre-diabetes to develop diabetic-range blood sugars, or a non-diabetic to show pre-diabetic blood sugars.--Increased small LDL particles--Though small LDL is highly variable during weight loss. When it does happen, it's probably from the interaction of VLDL (triglycerides) with LDL particles and the reaction that overloads LDL particles with triglycerides and conversion to small LDL particles.So why don't doctors often recognize these patterns when a patient loses weight? Because they rarely see it. Most of my colleagues are accustomed to having patients come back with weight gain, getting heavier and heavier each time. Lose weight? Impossible! So they just don't recognize weight loss effects when they see it. As followers of The Heart Scan Blog know, a frequent conversation around here is "Am I too skinny?" or "How do I stop losing weight?"The solution: Be patient. Be patient and wait about two months after a weight plateau has been achieved. That's when the numbers "settle down" and you see marked drops in triglycerides, increases in HDL, drops in blood sugar, reductions in small LDL.As with many things, it's all about timing. Why small LDL particles are the #1 cause of heart disease in the US 15. September 2011 William Davis (77) Ask your doctor: What is the #1 cause of heart disease in the US?Let's put aside smoking, since it is an eminently modifiable risk and none of those crazies read this blog anyway. What will your doctor say? Most like he or she will respond:High cholesterol or high LDL cholesterolToo much saturated fatObesityPfizer, Merck, AstraZeneca and their kind would be overjoyed to know that they can add your doctor to their eager following.I'd tell you something different. I would tell you that small LDL particles are, by far and away, the #1 cause for heart disease. I base this claim on several observations:--Having run over 10,000 lipoprotein panels (mostly NMR) over the past 15 years, it is a rare person who does not have a moderate, if not severe, excess of small LDL particles. 50%, 70%, even 90% or more small LDL particles are not rare. Over the course of a year, the only people who show no small LDL particles are slender, athletic, pre-menopausal females.--In studies in which lipoproteins have been quantified in people with coronary disease, small LDL particles dominate, just as they do in my office. Here's a 2006 review.--Small LDL is largely the province of people who consume carbohydrates, such as the American population instructed to "cut fat and eat more healthy whole grains." Conventional diet advice has therefore triggered an expllosion in small LDL particles.--When fasting triglycerides exceed 60 mg/dl, small LDL particles increase as a proportion of total LDL particles. This includes the majority of the US population. (This ignores postprandial, or after-eating, triglycerides, which also contribute to small LDL formation.)If you were to read the data, however, you might conclude that small LDL affects a minority of people. This is because in most studies small LDL categorize it as either "pattern B," meaning exceeding some arbitrary threshold of percentage of small LDL particles, versus "pattern A," meaning falling below that same arbitrary threshold.Problem: There is no consensus on what percentage of small LDL particles should mark the cutoff between pattern A vs. pattern B. In many studies, for instance, people with 50% small LDL particles are called "pattern A."If, instead, we were to set the bar lower to identify this highly atherogenic (atherosclerotic plaque-causing) particle at, say, 20-30% of total, then the number or percentage of people with "pattern B" small LDL particles would go much higher.I see this play out in my office and in the online program, Track Your Plaque, every day: At the start eating a low-fat, grain-filled diet with lots of visceral fat ("wheat belly") to start, they add back fat and cut out all wheat and limit carbohydrates. Small LDL particles plummet Even moore from Jimmy Moore 14. September 2011 William Davis (8) The ubiquitous and irrepressible Jimmy Moore posted even more commentary about the Wheat Belly phenomenon here, what he calls "The Wheat Belly Bonanza." Is low-carb really, at its core, little more than elimination of wheat? Sure, corn, rice, and sugar exert deleterious effects. But the dominant effect--by far--is the elimination of wheat. So is the low-carb movement really, at its core, a wheat-elimination movement?Food (non-wheat-containing, of course) for thought. Heart Scans: An Interview with Jimmy Moore 10. September 2011 William Davis (2) My friend, Jimmy Moore, of The Livin' La Vida Low Carb Show, posted this video of an interview I did with him.I provide some background on how heart scanning came about and how it led to the creation of the Track Your Plaque program. It reminds me how far we've come over the 8 years since the program got started. From its modest start as just an information resource to help people understand their heart scan score, to a comprehensive program that helps followers gain incredible control over coronary plaque and coronary risk that has now expanded to over 30 countries. High-tech heart procedures still dominate public consciousness, but the tremendous power of real heart disease prevention efforts are gaining more and more attention as each day passes. Wheat Belly #5 on New York Times Bestseller list! 9. September 2011 William Davis (66) The New York Times just released its bestseller list due for release September 18th, 2011 . . . .Wheat Belly is #5!! (That darned Jane Fonda woman elbowed me out for the #4 spot![caption id="attachment_4452" align="alignright" width="574" caption="Wheat Belly hits #5 on New York Times Bestseller List--in 1st week!"][/caption] Interview with Jimmy Moore of Livin' La Vida Low-Carb 7. September 2011 William Davis (11) Here's my podcast interview with Jimmy Moore, host of the Livin' La Vida Low-Carb Show. (If you want to fast forward to the interview, go to time marker 41:20 on the slidebar.)In the podcast, I talk about how the Track Your Plaque program and its focus on lipoprotein testing, along with the need to reverse the incredible epidemic of diabetes and pre-diabetes, led to elimination of all wheat from the diet and the book, Wheat Belly. An open letter to the Grain Foods Foundation 4. September 2011 William Davis (94) Readers: Please feel free to reproduce and disseminate this letter any way you see fit.To:Ms. Ashley Reynolds490 Bear Cub DriveRidgway, CO 81432Phone: 617.226.9927ashley.reynolds@mullen.comMs. Reynolds:I am writing in response to the press release from the Grain Foods Foundation that describes your effort to "discredit" the assertions made in my book, Wheat Belly: Lose the wheat, lose the weight and find your path back to health. I'd like to address several of the criticisms of the book made in the release:" . . . the author relies on anecdotal observations rather than scientific studies."While I do indeed have a large anecdotal experience removing wheat in thousands of people, witnessing incredible and unprecedented weight loss and health benefits, I also draw from the experiences already documented in clinical studies. Several hundred of these studies are cited in the book (of the thousands available) and listed in the Reference section over 16 pages. These are studies that document the neurologic impairment unique to wheat, including cerebellar ataxia and dementia; heart disease via provocation of the small LDL pattern; visceral fat accumulation and all its attendant health consequences; the process of glycation via amylopectin A of wheat that leads to cataracts, diabetes, and arthritis; among others. There are, in fact, a wealth of studies documenting the adverse, often crippling, effects of wheat consumption in humans and I draw from these published studies. "Wheat elimination 'means missing out on a wealth of essential nutrients.'"This is true--if the calories of wheat are replaced with candy, soft drinks, and fast food. But if lost wheat calories are replaced by healthy foods like vegetables, nuts, healthy oils, meats, eggs, cheese, avocados, and olives, then there is no nutrient deficiency that develops with elimination of wheat. There is no deficiency of any vitamin, including thiamine, folate, B12, iron, and B6; no mineral, including selenium, magnesium, and zinc; no polyphenol, flavonoid, or antioxidant; no lack of fiber. With regards to fiber, please note that the original studies documenting the health benefits of high fiber intake were fibers from vegetables, fruits, and nuts, not wheat or grains. People with celiac disease do indeed experience deficiencies of multiple vitamins and minerals after they eliminate all wheat and gluten from the diet. But this is not due to a diet lacking valuable nutrients, but from the incomplete healing of the gastrointestinal tract (such as the lining of the duodenum and proximal jejunum). In these people, the destructive effects of wheat are so overpowering that, unfortunately, some people never heal completely. These people do indeed require vitamin and mineral supplementation, as well as probiotics and pancreatic enzyme supplementation. I pose several questions to you and your organization:Why is the high-glycemic index of wheat products ignored? Due to the unique properties of amylopectin A, two slices of whole wheat bread increase blood sugar higher than many candy bars. High blood glucose leads to the process of glycation that, in turn, causes arthritis (cartilage glycation), cataracts (lens protein glycation), diabetes (glycotoxicity of pancreatic beta cells), hepatic de novo lipogenesis that increases triglycerides and, thereby, increases expression of atherogenic (heart disease-causing) small LDL particles, leading to heart attacks. Repetitive high blood sugars that develop from a grain-rich diet are, in my view, very destructive and lead to weight gain (specifically visceral fat), insulin resistance, leptin resistance (leading to obesity), and many of the health struggles Americans now experience. How do you account for the psychologic and neurologic effects of the wheat protein, gliadin?Wheat gliadin has been associated with cerebellar ataxia, peripheral neuropathy, gluten encephalopathy (dementia), behavioral outbursts in children with ADHD and autism, and paranoid delusions and auditory hallucinations in people with schizophrenia, severe and incapacitating effects for people suffering from these conditions. How do you explain the quadrupling of celiac disease over the last 50 years and its doubling over the last 20 years?I submit to you that, while this is indeed my speculation, it is the changes in genetic code and, thereby, antigenic profile, of the high-yield semi-dwarf wheat cultivars now on the market that account for the marked increase in celiac potential nationwide. As you know, "hybridization" techniques, including chemical mutagenesis to induce selective mutations, leads to development of unique strains that are not subject to animal or human safety testing--they are just brought to market and sold. Why does the wheat industry continue to call chemical mutagenesis, gamma irradiation, and x-ray irradiation "traditional breeding techniques" that you distinguish from genetic engineering? Chemical mutagenesis using the toxic mutagen, sodium azide, of course, is the method used to generate BASF's Clearfield herbicide-resistant wheat strain. These methods are being used on a wide scale to generate unique genetic strains that are, without question from the FDA or USDA, assumed to be safe for human consumption. In short, my view on the situation is that the U.S. government, with its repeated advice to "eat more healthy whole grains," transmitted via vehicles like the USDA Food Pyramid and Food Plate, coupled with the extensive genetic transformations of the wheat plant introduced by agricultural geneticists, underlie an incredible deterioration in American health. I propose that you and your organization, as well as the wheat industry and its supporters, are at risk for legal liability on a scale not seen since the tobacco industry was brought to task to pay for the countless millions who died at their product's hands. I would be happy and willing to talk to you personally. I would also welcome the opportunity to debate you or any of your experts in a public forum. Wiliam Davis, MDAuthor, Wheat Belly: Lose the wheat, lose the weight and find your path back to health (Rodale, 2011) << Older posts Newer posts >> Newer posts12...5678910111213...123124Older posts
Almonds are the new wheat 29. September 2011 William Davis (31) Once you eliminate this genetically-altered Frankengrain called modern wheat, the diet should center around vegetables, nuts, healthy oils like olive and coconut, fish, meats, cheese, olives, avocados and other real whole foods. This is, in fact, the diet that I have advocated in my heart disease prevention practice, as well as my online program for prevention and reversal of heart disease. But what if you'd like a piece of cheesecake or a nice slice of dessert bread---but you don't want to gain two pounds, spend 48 hours in the bathroom suffering with diarrhea and cramps, 3 weeks of joint pains and leg swelling, wade through mental "fog," anxiety, and rage just because you had that momentary indulgence---as you would with wheat? That's why I've been focusing on recipes that allow you to have something familiar, e.g., chocolate coconut bread or biscotti, but using ingredients that will not generate the metabolic contortions triggered by wheat. On perusing these recipes, you will notice that there are recurring ingredient themes. Many of the same ingredients pop up time and again. Among the most frequent, versatile, user-friendly, and tasty: Almonds. You can use almonds as ground whole almonds, ground blanched almonds for a finer texture, ground roasted almonds, almond butter (though, for maximum health benefits, I prefer the ground whole almonds). Ground almonds allow you to recreate muffins, breads, scones, pizza crust, pie crust, biscotti, and cookies with health benefits that exceed that of whole wheat---but with none of the downside: no weight gain, no high blood sugar, no triggering of small LDL particles (#1 cause of heart disease in the U.S.), no accumulation of visceral fat, no appetite stimulation. In short, you just have your chocolate almond biscotti or mocha cupcake and enjoy it, no health price to pay. So I call almonds the new wheat, except better.
Being regular is dangerous to your health 25. September 2011 William Davis (21) No, I'm not referring to your daily morning ritual in the bathroom. I'm talking about heart rate.Counterintuitively, a perfectly regular heart rate is a marker of poor health. People with perfect regularity of heart rate have more heart attacks, for instance.Regularity of heart rate occurs more commonly in people with hypertension and other metabolic derangements, and it signals increased risk for both heart attack and death. A perfectly regular heart rate, i.e., no variation in the time interval from beat to beat, suggests that the parasympathetic nervous system, the component of automatic ("autonomic") nervous system control that is associated with the relaxation response, feelings of well-being, quiet, and relaxation, is weak. It also means that the opposing sympathetic nervous sytem that regulates the "fight or flight," adrenaline-like response is allowed to be dominant. Dominance of the sympathetic over the parasympathetic system generates regularity of heart rate. Heart rate also tends to be faster, e.g., 85 beats per minutes rather than 55 or 60 beats per minute. So perfect regularity, as well as increased rate, is undesirable.What we want is irregularity of heart rate. But not irregularity that occurs chaotically with no rhyme or reason. More precisely, we want variability in heart rate. And we want variability to occur in synchrony with breathing, i.e., the respiratory cycle.The ideal response is:1) increase in heart rate with inspiration2) decrease in heart rate with expiration.Heart rate in healthy people typically varies 15-20 beats per minute within the respiratory cycle, e.g., 60 bpm at end-exhalation, 80 bpm at end-inspiration. Restoration of increased heart rate variability is associated with reduced blood pressure, reduced blood sugars (HbA1c), reduced inflammatory markers and cortisol (associated with stress), even an increase in DHEA levels. Feelings of well-being and calm also develop. Among the strategies to consider to restore heightened heart rate variability and slowed heart rate include:--Omega-3 fatty acid supplementation--Exercise--Weight loss--Deep breathing exercises--Meditation, prayer, and biofeedbackFor our Track Your Plaque purposes, we are folding in the HeartMath strategies, i.e., use of a heart rate monitor that calculates heart rate variability in the context of respiratory cycle. If you've not already done so, take a look at the two Special Reports devoted to this topic on the Track Your Plaque website.
You mean weight loss is hazardous to your health? 23. September 2011 William Davis (11) In my last Heart Scan Blog post, What is this wacky thing called weight loss?, I discussed how weight loss is associated with distortions in cholesterol and blood sugar values that can be very confusing, often leading your doctor to wrongly and unnecessarily prescribe drugs--since he/she likely rarely sees weight loss.Blog reader, Donald K., posted his enlightening story: I experienced this very thing. After losing serious weight from the eliminating wheat, processed, and sugary foods (1 year in total) I lost 130 pounds. When I was nearly finished I went to see my doctor. He wanted to put me on statins. I explained to him how the data does not support application to me (no evidence of heart disease) and I got the mantra about standards of practice, etc, etc. I held my ground and decided I am much happier eating dairy, eggs, grass fed beef, wild caught fish, and as much raw foods (nuts, veggies, fruits) as my body desires to treat my health parameters. Maintaining weight, it is easy. My BMI (23 down from 40) has remained constant for a few months now. You are right: metabolic processes definitely change. I no longer have sensations of glucose fluctuations or an uncontrolled appetite. I can only imagine the improved hormone regulation and metabolic communication going on inside my body. The symptoms from obesity, all gone. Goodbye sleep apnea, hypertension, hemorrhoids, arrhythmias, gastroinestinal disruptions, smelly body, chaffing thighs, and others not mentioned. The positive effects are just as dramatic, but I don’t want to ramble on. Weight loss? What is it? Getting your life back!Brace yourself: If you are following the nutrition advice posted here and in the Track Your Plaque program, or the discussion I've initiated in Wheat Belly, then you may find yourself in the very same health predicament as Donald. Arm yourself to protect yourself against the drug-wielding ways of doctors. No, weight loss to achieve ideal weight is definitely not bad for health. But your doctor's misinterpretation of its effects can be!
What is this wacky thing called "weight loss"? 20. September 2011 William Davis (41) I've discussed this before, but it has proven such an (encouragingly!) frequent issue that I thought it was worth discussing once again.What happens when you lose weight?The process of weight loss is characterized by multiple shifts in metabolic patterns that can be confusing. To the uninitiated eye, weight loss can look like a disastrous distortion in metabolism. The naive doctor on seeing your lab values, for instance, might insist you take a statin drug, a fibrate like Tricor (to reduce triglycerides or increase HDL), or simply berate you for your bad health habits--when it's actually a good thing you've accomplished.So when you lose weight, say, 30 pounds in 3 months, what have you accomplished?Energy stored as fat, especially from visceral fat stores, is mobilized into the bloodstream. It floods the bloodstream as fatty acids and triglycerides. These fatty acids and triglycerides don't occur in isolation, but interact with other particles and metabolic patterns. The resulting blood patterns include:--Increased triglycerides--An increase in triglycerides, for instance, from 90 mg/dl to 200 mg/dl in the midst of weight loss is common.--Reduced HDL--The flood of triglycerides leads to increased degradation of HDL, thus a drop. A drop in HDL from, say, 40 mg/dl to 27 mg/dl--very frightening to people--is exceptionally common.--Increased blood sugar--The flood of fatty acids and triglycerides results in insulin resistance, leading to higher blood sugars. It is not uncommon for someone with pre-diabetes to develop diabetic-range blood sugars, or a non-diabetic to show pre-diabetic blood sugars.--Increased small LDL particles--Though small LDL is highly variable during weight loss. When it does happen, it's probably from the interaction of VLDL (triglycerides) with LDL particles and the reaction that overloads LDL particles with triglycerides and conversion to small LDL particles.So why don't doctors often recognize these patterns when a patient loses weight? Because they rarely see it. Most of my colleagues are accustomed to having patients come back with weight gain, getting heavier and heavier each time. Lose weight? Impossible! So they just don't recognize weight loss effects when they see it. As followers of The Heart Scan Blog know, a frequent conversation around here is "Am I too skinny?" or "How do I stop losing weight?"The solution: Be patient. Be patient and wait about two months after a weight plateau has been achieved. That's when the numbers "settle down" and you see marked drops in triglycerides, increases in HDL, drops in blood sugar, reductions in small LDL.As with many things, it's all about timing.
Why small LDL particles are the #1 cause of heart disease in the US 15. September 2011 William Davis (77) Ask your doctor: What is the #1 cause of heart disease in the US?Let's put aside smoking, since it is an eminently modifiable risk and none of those crazies read this blog anyway. What will your doctor say? Most like he or she will respond:High cholesterol or high LDL cholesterolToo much saturated fatObesityPfizer, Merck, AstraZeneca and their kind would be overjoyed to know that they can add your doctor to their eager following.I'd tell you something different. I would tell you that small LDL particles are, by far and away, the #1 cause for heart disease. I base this claim on several observations:--Having run over 10,000 lipoprotein panels (mostly NMR) over the past 15 years, it is a rare person who does not have a moderate, if not severe, excess of small LDL particles. 50%, 70%, even 90% or more small LDL particles are not rare. Over the course of a year, the only people who show no small LDL particles are slender, athletic, pre-menopausal females.--In studies in which lipoproteins have been quantified in people with coronary disease, small LDL particles dominate, just as they do in my office. Here's a 2006 review.--Small LDL is largely the province of people who consume carbohydrates, such as the American population instructed to "cut fat and eat more healthy whole grains." Conventional diet advice has therefore triggered an expllosion in small LDL particles.--When fasting triglycerides exceed 60 mg/dl, small LDL particles increase as a proportion of total LDL particles. This includes the majority of the US population. (This ignores postprandial, or after-eating, triglycerides, which also contribute to small LDL formation.)If you were to read the data, however, you might conclude that small LDL affects a minority of people. This is because in most studies small LDL categorize it as either "pattern B," meaning exceeding some arbitrary threshold of percentage of small LDL particles, versus "pattern A," meaning falling below that same arbitrary threshold.Problem: There is no consensus on what percentage of small LDL particles should mark the cutoff between pattern A vs. pattern B. In many studies, for instance, people with 50% small LDL particles are called "pattern A."If, instead, we were to set the bar lower to identify this highly atherogenic (atherosclerotic plaque-causing) particle at, say, 20-30% of total, then the number or percentage of people with "pattern B" small LDL particles would go much higher.I see this play out in my office and in the online program, Track Your Plaque, every day: At the start eating a low-fat, grain-filled diet with lots of visceral fat ("wheat belly") to start, they add back fat and cut out all wheat and limit carbohydrates. Small LDL particles plummet
Even moore from Jimmy Moore 14. September 2011 William Davis (8) The ubiquitous and irrepressible Jimmy Moore posted even more commentary about the Wheat Belly phenomenon here, what he calls "The Wheat Belly Bonanza." Is low-carb really, at its core, little more than elimination of wheat? Sure, corn, rice, and sugar exert deleterious effects. But the dominant effect--by far--is the elimination of wheat. So is the low-carb movement really, at its core, a wheat-elimination movement?Food (non-wheat-containing, of course) for thought.
Heart Scans: An Interview with Jimmy Moore 10. September 2011 William Davis (2) My friend, Jimmy Moore, of The Livin' La Vida Low Carb Show, posted this video of an interview I did with him.I provide some background on how heart scanning came about and how it led to the creation of the Track Your Plaque program. It reminds me how far we've come over the 8 years since the program got started. From its modest start as just an information resource to help people understand their heart scan score, to a comprehensive program that helps followers gain incredible control over coronary plaque and coronary risk that has now expanded to over 30 countries. High-tech heart procedures still dominate public consciousness, but the tremendous power of real heart disease prevention efforts are gaining more and more attention as each day passes.
Wheat Belly #5 on New York Times Bestseller list! 9. September 2011 William Davis (66) The New York Times just released its bestseller list due for release September 18th, 2011 . . . .Wheat Belly is #5!! (That darned Jane Fonda woman elbowed me out for the #4 spot![caption id="attachment_4452" align="alignright" width="574" caption="Wheat Belly hits #5 on New York Times Bestseller List--in 1st week!"][/caption]
Interview with Jimmy Moore of Livin' La Vida Low-Carb 7. September 2011 William Davis (11) Here's my podcast interview with Jimmy Moore, host of the Livin' La Vida Low-Carb Show. (If you want to fast forward to the interview, go to time marker 41:20 on the slidebar.)In the podcast, I talk about how the Track Your Plaque program and its focus on lipoprotein testing, along with the need to reverse the incredible epidemic of diabetes and pre-diabetes, led to elimination of all wheat from the diet and the book, Wheat Belly.
An open letter to the Grain Foods Foundation 4. September 2011 William Davis (94) Readers: Please feel free to reproduce and disseminate this letter any way you see fit.To:Ms. Ashley Reynolds490 Bear Cub DriveRidgway, CO 81432Phone: 617.226.9927ashley.reynolds@mullen.comMs. Reynolds:I am writing in response to the press release from the Grain Foods Foundation that describes your effort to "discredit" the assertions made in my book, Wheat Belly: Lose the wheat, lose the weight and find your path back to health. I'd like to address several of the criticisms of the book made in the release:" . . . the author relies on anecdotal observations rather than scientific studies."While I do indeed have a large anecdotal experience removing wheat in thousands of people, witnessing incredible and unprecedented weight loss and health benefits, I also draw from the experiences already documented in clinical studies. Several hundred of these studies are cited in the book (of the thousands available) and listed in the Reference section over 16 pages. These are studies that document the neurologic impairment unique to wheat, including cerebellar ataxia and dementia; heart disease via provocation of the small LDL pattern; visceral fat accumulation and all its attendant health consequences; the process of glycation via amylopectin A of wheat that leads to cataracts, diabetes, and arthritis; among others. There are, in fact, a wealth of studies documenting the adverse, often crippling, effects of wheat consumption in humans and I draw from these published studies. "Wheat elimination 'means missing out on a wealth of essential nutrients.'"This is true--if the calories of wheat are replaced with candy, soft drinks, and fast food. But if lost wheat calories are replaced by healthy foods like vegetables, nuts, healthy oils, meats, eggs, cheese, avocados, and olives, then there is no nutrient deficiency that develops with elimination of wheat. There is no deficiency of any vitamin, including thiamine, folate, B12, iron, and B6; no mineral, including selenium, magnesium, and zinc; no polyphenol, flavonoid, or antioxidant; no lack of fiber. With regards to fiber, please note that the original studies documenting the health benefits of high fiber intake were fibers from vegetables, fruits, and nuts, not wheat or grains. People with celiac disease do indeed experience deficiencies of multiple vitamins and minerals after they eliminate all wheat and gluten from the diet. But this is not due to a diet lacking valuable nutrients, but from the incomplete healing of the gastrointestinal tract (such as the lining of the duodenum and proximal jejunum). In these people, the destructive effects of wheat are so overpowering that, unfortunately, some people never heal completely. These people do indeed require vitamin and mineral supplementation, as well as probiotics and pancreatic enzyme supplementation. I pose several questions to you and your organization:Why is the high-glycemic index of wheat products ignored? Due to the unique properties of amylopectin A, two slices of whole wheat bread increase blood sugar higher than many candy bars. High blood glucose leads to the process of glycation that, in turn, causes arthritis (cartilage glycation), cataracts (lens protein glycation), diabetes (glycotoxicity of pancreatic beta cells), hepatic de novo lipogenesis that increases triglycerides and, thereby, increases expression of atherogenic (heart disease-causing) small LDL particles, leading to heart attacks. Repetitive high blood sugars that develop from a grain-rich diet are, in my view, very destructive and lead to weight gain (specifically visceral fat), insulin resistance, leptin resistance (leading to obesity), and many of the health struggles Americans now experience. How do you account for the psychologic and neurologic effects of the wheat protein, gliadin?Wheat gliadin has been associated with cerebellar ataxia, peripheral neuropathy, gluten encephalopathy (dementia), behavioral outbursts in children with ADHD and autism, and paranoid delusions and auditory hallucinations in people with schizophrenia, severe and incapacitating effects for people suffering from these conditions. How do you explain the quadrupling of celiac disease over the last 50 years and its doubling over the last 20 years?I submit to you that, while this is indeed my speculation, it is the changes in genetic code and, thereby, antigenic profile, of the high-yield semi-dwarf wheat cultivars now on the market that account for the marked increase in celiac potential nationwide. As you know, "hybridization" techniques, including chemical mutagenesis to induce selective mutations, leads to development of unique strains that are not subject to animal or human safety testing--they are just brought to market and sold. Why does the wheat industry continue to call chemical mutagenesis, gamma irradiation, and x-ray irradiation "traditional breeding techniques" that you distinguish from genetic engineering? Chemical mutagenesis using the toxic mutagen, sodium azide, of course, is the method used to generate BASF's Clearfield herbicide-resistant wheat strain. These methods are being used on a wide scale to generate unique genetic strains that are, without question from the FDA or USDA, assumed to be safe for human consumption. In short, my view on the situation is that the U.S. government, with its repeated advice to "eat more healthy whole grains," transmitted via vehicles like the USDA Food Pyramid and Food Plate, coupled with the extensive genetic transformations of the wheat plant introduced by agricultural geneticists, underlie an incredible deterioration in American health. I propose that you and your organization, as well as the wheat industry and its supporters, are at risk for legal liability on a scale not seen since the tobacco industry was brought to task to pay for the countless millions who died at their product's hands. I would be happy and willing to talk to you personally. I would also welcome the opportunity to debate you or any of your experts in a public forum. Wiliam Davis, MDAuthor, Wheat Belly: Lose the wheat, lose the weight and find your path back to health (Rodale, 2011)